Overseas Income Assessment Form

OVFA Complete this form if you’re resident overseas
Name:
Customer Reference Number:
National Insurance Number:
Date of birth:
Overseas Income Assessment Form
You must complete all the sections that apply to you, sign and return the form with your photocopied
evidence. Remember to pay the correct postage.
Section 1 - Residency questions and details check
Date you left/will leave the UK
Date you will return to the UK (if known) Country of overseas residence
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-
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Check your National Insurance number and date of birth shown above. If any details are incorrect, please
update them.
National Insurance number
Date of birth
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Section 2 – Employment Information
Tick the section that applies to you and where you see e , you should refer to the Evidence Information
Sheet to find out what evidence you need to send us along with your completed form.
Employed e
Date employment started/will start
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Gross Annual Income
Currency of income
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Read the Evidence Information Sheet and make sure you send all the evidence we need.
Self-employed e
Date self-employment started/will start
-
Currency of income
Gross Annual Income
-
Read the Evidence Information Sheet and make sure you send all the evidence we need.
Not in employment e
If you’re in further study, supported by a third party, travelling abroad or volunteering read the Evidence
Information Sheet and make sure you send all the evidence we need.
Section 3 - Third Party Declaration
If you’re financially supported by a third party please have that person complete this section and
confirm how much they support you.
I confirm that I financially support the person named on this form
Third party signature
Print name
Third party address
Total amount of support
(Weekly/Monthly/Annually)
£
Today’s date
Postcode
ICR/OVFA
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1
Section 4 - Your UK Bank/Building Society Account Details
The easiest way to make repayments whilst overseas is to set up a monthly Direct Debit. Simply
complete the section below with your UK bank or building society account details and we’ll arrange this
for you. If you don’t already have a UK account, you’ll need to set one up to pay by Direct Debit.
Instruction to your
Bank or Building Society
to pay by Direct Debit
Please complete the whole form using a ball point pen and send it to:
Student Loans Company Limited,
100 Bothwell Street,
Glasgow
G2 7JD.
Service User Number
Name(s) of Account Holder(s)
9
0
7
0
2
1
Reference
Bank/Building Society account number
Instruction to your Bank or Building Society
Branch Sort Code
Please pay Student Loans Company Limited Direct
Debits from the account detailed on this Instruction
subject to the safeguards assured by the Direct Debit
Guarantee.
I understand that this instruction may remain with the
Student Loans Company Limited and, if so, details will
be passed electronically to my Bank/Building Society.
(from the top right hand corner of your cheque)
Name and full postal address of your Bank or Building Society
To The Manager
Bank/Building Society
Address
Postcode
Banks and Building Societies may not accept Direct Debit Instructions for some types of account.
Section 5 - Personal Details
If any of your personal details have changed please update them below and tell us your most up to date
contact details. Include the international dial code for all phone numbers.
Title
Home phone
number
Forename(s)
Work/term
phone number
Surname
Mobile
Email address
Address
Country
Postcode
Section 6 - Customer Declaration
This must be signed and dated or we cannot process your form. Any information found to be false may be
regarded as fraudulent.
I confirm that the information I have given on this form is true and correct. I understand that Student
Loans Company Limited (SLC) reserves the right to request additional information and/or to verify the
information I have provided. I authorise the organisation(s) and person(s) detailed in this form to provide
SLC with confirmation and further information that they may request.
Your signature
Today’s date
2
ICR/OVFA